NOVEL INSIGHTS INTO DIAGNOSTIC UTILITY OF NPAR IN PREDICTING INFLAMMATORY STATUS IN CRITICAL PATIENTS IN TERTIARY HEALTHCARE SETTINGS
DOI:
https://doi.org/10.71000/hngy3w13Keywords:
Neutrophil percentage-to-albumin ratio, NPAR, Critical care; , Inflammation, Biomarker, Systemic inflammatory responseAbstract
Objective: To evaluate the diagnostic value of neutrophil percentage-to-albumin ratio (NPAR) for detecting inflammatory status in critically ill patients as well as comparing its performance with conventional inflammatory markers.
Methods: This prospective observational study was carried out in the Intensive Care Unit (ICU) of Mayo Hospital, Lahore, between October 2023 and March 2024. 150 critically ill adult patients were recruited. Within 24 hours of admission, blood samples were collected to measure neutrophil percentage and serum albumin levels, and NPAR was calculated by dividing neutrophil percentage by the serum albumin concentration (g/dL). The patients were divided into high-inflammatory and low-inflammatory groups based on levels of C-reactive protein (CRP) and procalcitonin (PCT). Association between NPAR and inflammatory markers were evaluated using receiver operating characteristic (ROC) curve analysis and correlation analyses. A p-value of less than 0.05 was considered statistically significance.
Results: The mean NPAR scores were significantly greater in patients with high inflammatory status compared to those with lesser inflammation levels (0.085 ± 0.02 vs. 0.046 ± 0.01; p < 0.001). NPAR was also found to have a strong positive correlation with CRP (r = 0.68, p = 0.01) and PCT (r = 0.61, p = 0.02). ROC analysis showed an excellent diagnostic performance to identify systemic inflammation (AUC = 0.82; sensitivity = 80.0% , specificity = 74.5%), similar to standard inflammatory markers.
Conclusion: NPAR is an inexpensive, universally accessible biomarker that has a high level of diagnostic accuracy in evaluating inflammatory conditions of critically ill patients. Its inclusion in routine laboratory assessments could lead to timely interventions and subsequent detection. Additional multicentric investigations would be justified to determine standard cut-off values and confirm its prognostic value.
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